Dermatopathologic Variants of Malignant Melanoma
Section snippets
BIOPSY TECHNIQUE
Ideally, all biopsy procedures for malignant melanoma would accomplish complete excision of the lesion to the depth of subcutaneous tissue. Melanoma, however, is not always suspected clinically. In particular, this situation prevails with unusual variants of melanoma, such as desmoplastic or amelanotic lesions. Nonetheless, when melanoma is considered in the differential diagnosis, an excisional biopsy is recommended. This approach allows adequate distinction of the neoplasm from the
HISTOPATHOLOGIC CLASSIFICATION OF MALIGNANT MELANOMA
Superficial spreading malignant melanoma, lentigo maligna melanoma, nodular melanoma, and acral lentiginous melanoma account for most cases of malignant melanoma. The remaining melanomas (less than 5% of cases) are unusual histopathologic subtypes.
Desmoplastic malignant melanoma is probably the most common of the unusual melanoma subtypes. As its name implies, desmoplastic melanoma occurs in conjunction with a fibrotic connective tissue stroma. Most often, desmoplastic melanoma arises in the
IMMUNOHISTOCHEMISTRY
S-100 protein is a 21-kd protein that was extracted originally from bovine brain in 1965.24 Since then, S-100 protein has been noted in the peripheral nerves and central nervous system of many vertebrates and in melanocytes and other isolated cells, such as Langerhans' cells.25 S-100 protein stains 96.4% of malignant melanomas and 98.4% of benign melanocytic nevi.26 In addition, it stains 15.1 % of nonmelanocytes,26 primarily neural and Langerhans' cells. S-100 protein is a sensitive
SIMULATORS OF MALIGNANT MELANOMA
Several benign and malignant neoplasms simulate malignant melanoma and can cause difficulty for pathologists or dermatopathologists. Spitz nevi usually are sharply circumscribed but may have a substantial intraepidermal component. Eosinophilic globules (Kamino bodies) may be present in the papillary dermis, a finding that can be an aid to diagnosis.34 A variant of the Spitz nevus, the pigmented spindle cell nevus of Reed,17 is sharply demarcated but heavily pigmented and shows a preponderance
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Cited by (45)
ATP-binding cassette transporter ABCB5 gene is expressed with variability in malignant melanoma
2010, Actas Dermo-SifiliograficasCitation Excerpt :Melanoma is a heterogeneous malignant disease characterized by four main histopathological types: acral, nodular, superficial spreading and lentigo maligna melanama (AM, NM, SSM and LMM, respectively). Among the molecular differences between them, there are genomic amplifications and differentially expressed genes in AM tumors, point mutations (BRAF, V600E) in SSM and deletions that involve the 1p36 chromosome in 63% of NM.32,33 Human cancer distribution is influenced by genetic background, local habits and environment.
Skin and adnexal structures
2010, Differential Diagnosis in Surgical PathologySkin and adnexal structures
2009, Differential Diagnosis in Surgical Pathology: Expert Consult - Online and PrintLentigines, nevi, and melanomas
2009, Weedon's Skin Pathology: Third EditionAmelanotic melanoma misdiagnosed as a diabetic foot ulcer
2007, Journal of Diabetes and its ComplicationsCitation Excerpt :It accounts for approximately 4% of all skin cancers, but it is responsible for 79% of all skin-cancer-related deaths (Franke, Neumann, Ruzicka, & Schulte, 2000). Unusual variants of melanoma, including amelanotic melanoma, constitute less than 5% of all melanomas (Perniciaro, 1997). Amelanotic melanoma may be located on various sites of the body.
Malignant melanoma in the 21st century, part 1: Epidemiology, risk factors, screening, prevention, and diagnosis
2007, Mayo Clinic ProceedingsCitation Excerpt :The overall incidence of melanoma in these ethnic groups is low compared with that in white patients. Acral lentiginous melanoma occurs on glabrous skin and adjacent skin of the digits, palms, and soles.143,151,158–165 On the soles, acral lentiginous melanomas often involve heels.141,159